准分子激光原位角膜磨镶术治疗远视眼老视的临床观察

目的 探讨准分子激光原位角膜磨镶术(LASIK)治疗远视眼老视的临床效果.方法 回顾性病例分析研究.收集32例(64只眼)因远视眼老视行LASIK患者的资料.术前屈光度数:球镜为+0.75～+3.00 D,柱镜为0.00～+1.75 D.术后预期目标屈光度数:主视眼为0.00～-0.50 D视远,非主视眼为-1.50～-2.50 D视近,目标近视力等于或高于J3.术后随访时间12个月,观察术后双眼裸眼远近视力、角膜形态、屈光度数及对比敏感度等.本研究采用t检验、X2检验、SNK-q检验方法对数据进行统计学分析.结果 LASIK术后12个月双眼裸眼远视力≥0.8且近视力等于或高于J3及等于或高于J4的患者分别为53.1%(17/32)及87.5%(28/32).术后不同时间角膜屈光力较术前角膜直径3 mm区域为(44.12±1.38)D、5 mm区域为(43.42±1.53)D]均有明显增加,且对应的角膜非球面参数Q值,如主视眼术后1、3、 6、 12个月分别为-0.514±0.053、-0.416±0.065、-0.389±0.076、-0.368±0.087,亦呈负值增加(t=19.25,12.14,9.82,8.11;P<0.01).术后12个月等效球镜屈光度数与预期目标差值在±0.50 D和±1.00 D以内者主视眼分别为87.5%(28/32)、100.0%(32/32),非主视眼分别为56.2%(18/32)、90.6%(29/32).术后6个月双眼各空间频率对比敏感度与术前比较,差异均无统计学意义(t:0.63,0.45,0.37,1.06,0.64;P0.05);术后12个月主诉有干眼症状的患者占15.6%(10/23),满意度调查84.4%(27/32)患者对疗效满意.结论 根据单眼视原理采用LASIK治疗远视眼老视可获得较好的临床效果,但其远期疗效和稳定性有待进一步观察.

Clinic observation of laser in situ keratomileusis for treatment of presbyopia with hypermetropia

Objective To investigate the effects of laser in situ keratomileusis(LASIK)for treatment of presbyopia with hypermetropi& Methods 32 presbyopia patients(64 eyes)with hypermetropia were treated by LASIK and follow-up 1 year.The preoperative sphere was+0.75 to +3.00 D and cylinder was 0.00 to +1.75 D.For distance vision correction,the target refraction was 0.00 to-0.50 D in the dominant eye.And for near vision,the target refraction was-1.50 to-2.50 D in the non-dominant eye.The measurement including refraction,uncorrected visual acuity(UCVA),near vision,Q factor of cornea and contrast sensitivity were recorded.Results At 1 year after surgery a toted of 53.1%(17/32)of all patients had binocular distance UCVA of 20/25 or better along with J3or better near,and along with J4orbetter near was 87.5%(28/32).The postoperative corneal refractive power was significant higher than preoperative3mm:(44.12±1.38)D,5 mm:(43.42±1.53)D] and Q factor became more negative.At 1 year 87.5%(28/32)and 100.0%(32/32)of the dominant eyes treated for distance had a manifest refractive spherical equivalent within±0.50 and±1.00 D of intended correction,respectively;of the non-dominant eyes treated for near,56.2%(18/32)and 90.6%(29/32)had a manifest refractive spherical equivalent within±0.50 and±1.00 D of intended correction respectively.The difference of sensitivity was no statistically significant between preoperative and 6 months after surgery.There were 15.6% of the eyes had dry eye syndrome and 84.4% of the patients were satisfied with LASIK at 1 year after surgery.Conclusions LASIK was a effect surgery for treatment of presbyopia with hypermetropia.